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CC BY-NC-ND 4.0 · Journal of Coloproctology 2023; 43(01): 018-023
DOI: 10.1055/s-0043-1764196
Original Article

The Effect of Transvaginal Prolapse Surgery on Anorectal Function

Rachel E. Colbran
1   Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia
2   Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
,
Andrea M. Warwick
1   Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia
2   Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
3   Brisbane Academic Functional Colorectal Unit, Brisbane, Queensland, Australia
,
Hannah G. Krause
1   Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia
,
Judith T. Goh
1   Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia
4   School of Medicine, Griffith University, Gold Coast, Queensland, Australia
,
Christopher J. Gillespie 
1   Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia
2   Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
3   Brisbane Academic Functional Colorectal Unit, Brisbane, Queensland, Australia
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Abstract

Objective Pelvic floor dysfunction can manifest as a spectrum including anorectal dysfunction, vaginal prolapse, and urinary incontinence. Sacrospinous fixation is a procedure performed by gynecologists to treat vaginal prolapse. The present study aims to evaluate the impact of transvaginal prolapse surgery on anorectal function.

Materials and Methods We conducted a retrospective review of patients undergoing sacrospinous fixation surgery for vaginal prolapse between 2014 to 2020. Those with anorectal dysfunction who had also been evaluated by the colorectal service preoperatively and postoperatively were included for analysis. These patients were assessed with symptom-specific validated questionnaires. The effect of surgery on constipation and fecal incontinence symptoms was analyzed.

Results A total of 22 patients were included for analysis. All patients underwent transvaginal sacrospinous fixation, and 95.4% also had posterior colporrhaphy for vaginal prolapse. There were a statistically significant improvements in the Fecal Incontinence Severity Index (FISI), the St. Mark's Incontinence Score (Vaizey), the embarrassment and lifestyle components of the Fecal Incontinence Quality of Life Score, the Constipation Scoring System, the Obstructed Defecation Score, and components of the Patient Assessment of Constipation Quality of Life score.

Conclusion Transvaginal prolapse surgery leads to a favorable effect on anorectal function, with improvements in both obstructed defecation and fecal incontinence scores in this small series.

Keywords

obstructed defecation - fecal incontinence - transvaginal prolapse surgery - pelvic floor - sacrospinous fixation

Synopsis

Transvaginal prolapse surgery leads to a favorable effect on anorectal function with improvements in both obstructed defecation and fecal incontinence scores.


Author Contributions

AW and CG were involved in study conceptualization, design, and methodology. RC performed data collection and analysis, and wrote the original draft. All authors were involved in reviewing and editing the final manuscript.




Publication History

Received: 08 January 2023

Accepted: 23 January 2023

Article published online:
22 March 2023

© 2023. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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